An Intersectional Approach to Cervical Cancer Screening Disparities by Race/Ethnicity and Immigrant Status

Area of Science:

• Public Health
• Epidemiology
• Health Disparities Research

Background:

• Significant disparities in cervical cancer (CC) screening exist among racial/ethnic minority and immigrant populations.
• Existing research inadequately explains the combined impact of race/ethnicity and immigrant status on CC screening.
• Understanding these joint influences is critical for developing targeted public health interventions.

Purpose of the Study:

• To investigate the joint influence of race/ethnicity and immigrant status on cervical cancer screening.
• To identify specific barriers contributing to observed disparities in CC screening among immigrant women.
• To inform culturally and linguistically appropriate strategies for improving CC screening.

Main Methods:

• Cross-sectional analysis utilizing data from 25,660 U.S. women across the 2005, 2010, and 2015 National Health Interview Surveys.
• Logistic regression models were employed to analyze cervical cancer screening status by race/ethnicity and immigrant status.
• Mediating factors including socioeconomic status, healthcare access, language, and acculturation were incorporated to explain disparities.

Main Results:

• All immigrant groups exhibited lower odds of being up-to-date with cervical cancer screening compared to U.S.-born non-Hispanic White women.
• Foreign-born non-Hispanic Asians had the lowest screening odds (aOR: 0.36), followed by foreign-born non-Hispanic Whites, Hispanic/Latinx, and non-Hispanic Black women.
• Socioeconomic status and healthcare access partially explained disparities for foreign-born Hispanic/Latinx and non-Hispanic Black women, while language and acculturation were key for all immigrant groups.

Conclusions:

• Cervical cancer screening disparities are primarily concentrated within immigrant populations across various racial/ethnic groups.
• Targeting insurance and healthcare access is recommended for immigrant Hispanic/Latinx and non-Hispanic Black women.
• Culturally and linguistically competent care and targeted education are essential for immigrant non-Hispanic Asian and White women to reduce screening disparities.